Download the supplement (208 p.) - KCE
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<strong>KCE</strong> reports vol. 40 APPENDICES Physio<strong>the</strong>rapy 125<br />
On average, <strong>the</strong> oldest people are treated by ambulatory physio<strong>the</strong>rapists for cardiovascular (mean age: 69<br />
years; high prevalence of stroke/cardiovascular disorders), male genital (mean age: 65 years; high prevalence of<br />
prostatectomy), and neurological (mean age: 64 years; high prevalence of gait disorders,<br />
hemiplegia/hemiparesis, and Parkinson) disorders as well as for general and unspecified conditions (mean age:<br />
64 years; high prevalence of orthopaedic joint implants). On <strong>the</strong> contrary, youngest people are treated for<br />
psychological (mean age: 26 years; high prevalence of delayed milestone and learning problems),<br />
endocrine/metabolic/nutritional (mean age: 28 years; high prevalence of cystic fibrosis), and<br />
pregnancy/childbearing/family planning (mean age: 31 years) conditions.<br />
A very high prevalence of females is logically observed in pregnancy/childbearing/family planning, female genital,<br />
and urological (higher prevalence of urinary incontinence) conditions while, of course, male genital category<br />
concerns exclusively males. A higher prevalence of females is also found in <strong>the</strong> pathology categories that mainly<br />
affect older people presumably due to <strong>the</strong> higher life expectancy of females.<br />
Information that results from Belgian nomenclature codes (i.e., place of <strong>the</strong> rehabilitation, length of <strong>the</strong> session,<br />
type of pathology treated, and fee cost of <strong>the</strong> session) is presented in Appendix 4.H.<br />
Pathology categories primarily treated in physio<strong>the</strong>rapists office are musculoskeletal, psychological, urological,<br />
and pregnancy/childbearing/family planning conditions. Neurological and respiratory disorders are more<br />
frequently treated in patients home.<br />
Overall, <strong>the</strong> mean length of a session is 29 ± 4 minutes. Thirty minutes are <strong>the</strong> most frequent length observed<br />
in <strong>the</strong> questionnaire. Almost no sessions were allocated for consultative examination and written report (see<br />
Section 4.2.2.3).<br />
A high prevalence of common pathologies is observed in musculoskeletal and urological disorders. Heavy<br />
pathologies are generally encountered in neurological (high prevalence of hemiplegia/hemiparesis, Parkinson,<br />
multiple sclerosis, and cerebral palsy) and cardiovascular (high prevalence of stroke/cardiovascular diseases)<br />
disorders. Perinatal pathologies logically concern pregnancy/childbearing/family planning conditions. Pathologies<br />
of acute FA list are frequent in general and unspecified conditions (high prevalence of orthopaedic joint<br />
implants) and, to a lesser extent, in musculoskeletal disorders (due to <strong>the</strong> prevalence of fractures, sprain/strain<br />
of knee, internal derangement of knee, and rotator cuff syndrome). Pathologies of chronic FB list are mainly<br />
encountered in psychological conditions (high prevalence of learning problems and delayed milestone) and, to a<br />
lesser extent, in neurological disorders (high prevalence of gait disorders).<br />
Finally, fee cost for a session is on average equivalent to 16.72 ± 3.12 euros; 18.00 euros being <strong>the</strong> most<br />
frequent fee cost observed in <strong>the</strong> questionnaire.<br />
Physio<strong>the</strong>rapeutic Statistical Classification of Diseases and Related Health Problems 10 th<br />
Revision (ICD-10)<br />
As formulated in <strong>the</strong> previous section, one physio<strong>the</strong>rapeutic session may be used to treat more than one<br />
condition when co-morbidity exists. In such situation, <strong>the</strong> session was divided into <strong>the</strong> number of<br />
RFT/conditions that are treated during this session if <strong>the</strong>y belong to different ICD-10 chapters. As a result, <strong>the</strong><br />
5170 examined sessions increased up to 5449 reasons for treatment. The number and <strong>the</strong> proportion of RFT<br />
according to each of <strong>the</strong> 21 ICD-10 chapters are illustrated in Figure 4.3. Most of <strong>the</strong> pathologies treated in<br />
Belgium during ambulatory physio<strong>the</strong>rapeutic sessions refer to diseases of <strong>the</strong> musculoskeletal system and<br />
connective tissue (37.62 1.29%), diseases of <strong>the</strong> nervous system (15.34 0.96%), and injury, poisoning and<br />
certain o<strong>the</strong>r consequences of external causes (12.48 0.88%).<br />
The most common RFT classified in diseases of <strong>the</strong> musculoskeletal system and connective tissue included:<br />
Low back pain (n = 332; 16 2% of <strong>the</strong> musculoskeletal diseases)<br />
Arthosis/polyarthrosis (n= 245; 12 2%)<br />
Cervicalgia (n = 204; 10 1%)<br />
En<strong>the</strong>sopathy/tendinitis (n = 169; 8 1%)<br />
Adhesive capsulitis of shoulder (n = 119; 6 1%)<br />
Internal derangement of knee (n = 99; 5 1%)<br />
Dorsalgia (n = 95; 5 1%)